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A. OAB symptoms are more common as people age, but they are not a normal part of ageing. They can be treated.
If you have bothersome symptoms, it is important that you go to your doctor. Try not to be embarrassed in discussing your situation.
If self-management and lifestyle changes cannot control your symptoms, your doctor may suggest drug therapy.
The goal is to reduce the urgent need to urinate and the number of times you need to go, as well as to prevent leakage episodes. Drugs used for OAB are antimuscarinic drugs or mirabegron (beta-3 agonist). Together with your doctor, you can decide which type of drug treatment is best for you.
A. Factors which influence this decision include:
A. Drug therapy with antimuscarinics:
Antimuscarinics or Muscarinic receptor antagonists (MRAs) are a group of drugs which reduce the abnormal contractions of the bladder and improve urgency symptoms.
There are several MRAs. These work similarly, but they may have different side effects and be more or less tolerated by patients.
A. Most antimuscarinics are taken by mouth once daily with or without food, although they can also be administered through a transdermal patch. The recommended dose for adults differs by the type of MRA. Start with the minimum dosage that gives you the beneficial effects of the drug with as few side effects as possible.
A. Muscarinic receptors exist throughout the body. Drug treatment for bladder contractions affects all of these receptors throughout the body. As a result, you may have side effects.
Antimuscarinics can cause confusion, memory loss, and worsening mental function in older people. If an MRA is prescribed, your doctor may consider to modificate other medications to help reduce side effects.
If you experience side-effects, contact your doctor to reconsider your therapy. Options might include:
A. Antimuscarinics are not recommended for patients who are pregnant or those who suffer from conditions like:
A. Beta-3 agonists (β3-agonists) are a new class of drugs. They target β3 receptors in the bladder muscle. This signals the bladder muscle to relax. As a result, bladder contractions are reduced. Your bladder can hold urine longer, and you will feel the need to urinate less often. Currently, only one β3 agonist-Mirabegron-is available for the treatment of OAB symptoms.
A. Mirabegron is taken by mouth once daily with or without food. Swallow the pill whole; do not break it up or crush it. The adult dose is usually 50 mg.
A. Drug treatment for bladder contractions affects nerve endings throughout the body. As a result, you may have side effects.
| Common side effects | Contact your doctor right away if you experience: |
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A. Beta-3 agonist is not recommended for patients who:
A. Schedule an appointment (follow-up) to see your doctor after starting drug treatment. You and your doctor will discuss whether drug treatment seems to be helping and any side effects you have. Your doctor will also check your blood pressure or prescribe further tests such as a bladder diary.
A. Sometimes the drug your doctor prescribed does not improve your symptoms. In that case, your doctor might switch you to another drug, antimuscarinic (MRA) or β3-agonist, or other treatment options. Together with your doctor, you can decide which approach is best for you.
Common other treatment options for OAB symptoms are: